Angelica Pabon with her 3-year-old daughter, Liliana, attends Erie Neighborhood House in Chicago, Ill., a preschool program that provides academic and mental health services for young children who have witnessed violence, Sept. 11, 2014. Her older child, Julian, received help there after witnessing the murder of his father. Courtesy of The Hechinger Report

Angelica Pabon with her 3-year-old daughter, Liliana, attends Erie Neighborhood House in Chicago, Ill., a preschool program that provides academic and mental health services for young children who have witnessed violence, Sept. 11, 2014. Her older child, Julian, received help there after witnessing the murder of his father. Courtesy of The Hechinger Report

Few preschools are equipped to help children exposed to violence

When 3-year-old Julian started throwing tantrums in a Chicago preschool, his teachers were unsure how to handle him. His screaming, inconsolable crying and violent outbursts soon escalated to the point where he threw a chair at a teacher. He was subsequently kicked out of the child care program.

His mother, Angelica Pabon, knew the reason for Julian’s anger and aggression: A few months earlier, the young boy had witnessed his father being shot to death. To recover from the traumatic experience, Julian needed a preschool capable of working through his emotional problems while supporting his academic growth.

After a referral from a social worker, Pabon enrolled Julian at Erie Neighborhood House, one of the few early childhood programs in Chicago that offer educational and mental health services for young children. There, he received close attention from teachers in a therapeutic classroom to control his anger. He also attended one-on-one “play therapy” sessions with a psychologist. That was six years ago. Today, Julian’s mother says, he’s a 9-year-old doing well in fourth grade at a Chicago public school.

“If I hadn’t come to this program, they would have placed Julian in special education, not because that’s where his mind is, but because of the way he was acting,” said Pabon, 28, a single mother of four who works in a hospital insurance department.

Julian’s case illustrates a larger, more complex issue simmering within many of the nation’s early childhood centers serving children affected by violence and poverty. According to a recent nationally representative surveypublished in JAMA Pediatrics, 13 percent of infants 1 year old and younger and 44 percent of 2- to 5-year-olds were assault victims in the previous year, primarily at the hands of siblings and peers.

Nearly 8 percent of infants and 14 percent of 2-to 5-year-olds had witnessed violence. Other studies have had similar findings.

Most assaults on young children didn’t involve weapons or result in injury, and siblings and playmates were the most common perpetrators. Still, early education experts say, any experience of violence can be traumatic. Yet few preschools have mental health professionals on staff, leaving many children in danger of falling through the cracks. Early investment would save money as well as heartache later on, some experts say.

“If we put that money at the front end, we will spend less on special education classes for behavior disorder, we will spend less on adolescent substance abuse, we will spend less on gang violence, we will spend less on the juvenile criminal justice system,” said Margret Nickels, a clinical psychologist at Chicago’s Erikson Institute who’s known as an authority on early childhood mental health.

To offer mental health services, Erie spends $160,000 annually for a full-time psychologist and social worker who provide treatment for about 70 children each year. Erie also relies heavily on unpaid graduate students, and officials estimate the value of their services is more than double the current budget, which is supported by federal, state and private funds.

Erie psychologist Elizabeth Yelen, who’s treated hundreds of children in her 16-year career, said traumatized young learners who didn’t get help in the early years were in danger of long-term academic difficulties that were far more expensive.

“A lot of them go to school with less information because their behavior impacts their learning,” she said. “They’re already feeling bad because they might have failed in preschool, which is hard to fathom, but it happens.”

She said children did better in school when they came out of preschool feeling safe and successful and knowing how to interact with their peers.

In the case of Julian, whose last name is being withheld for his protection, the boy was showing a range of intense emotions, from anger and aggression to profound sadness and neediness. He was breaking down, Yelen said. The beginning of his treatment, and in some ways the key to his later success, started with a simple act: A teacher held him.

“The teacher who was in that classroom at the time held him a lot,” Yelen said.“He needed to be held. He needed to be nurtured. And that’s what we were doing.”

For children such as Julian who’ve witnessed murder, “how much scarier can it get?” she said. “They are completely flooded with anxiety. A lot of our job is helping them to feel safe. And if you feel safe, you can learn.”

Two of Julian’s siblings, 5-year-old Anjel and 3-year-old Liliana, are now enrolled at Erie.

Nickels said she still encountered ignorance on the topic from child care workers, preschool teachers and even principals who wrongly thought that young children didn’t understand what was happening and weren’t affected.

“Shouting, watching your parent get hit; these are emotional and physiological experiences that even infants perceive and trigger intense stress reactions,” Nickels said.

During nap time at Erie, teachers meet with Yelen and her psychology students to develop plans for emotional growth through play therapy and academic growth in the classroom.

On the building’s lower level, children who need individual attention participate in weekly play therapy sessions with Yelen or one of the graduate students. Of the 174 children at Erie, about 70 receive play therapy services or psychological evaluations.

Erie preschool teacher Angelic Santos, who’s taught young children for 10 years, said the collaboration between teachers and psychologists was crucial to connecting educational and emotional goals.

“We can help them to focus and even find solace in education and going to school,” Santos said.

Although much attention focuses on traumatized children who display anger and aggression, others show more subtle behavioral changes that translate into quiet cries for help.

Two years ago, Ana Perez recalled, a domestic violence incident led her then-3-year-old daughter, Angie, to change dramatically from playful to withdrawn.

Angie became a perfectionist, so obsessed with clothes and her appearance that she’d cry if she didn’t like how she looked. Yelen said it was common for kids to manifest their internal struggles with a fixation on appearance.

After two years of therapy at Erie, along with family therapy, Angie, who’s now 5 and in kindergarten, has gained self-confidence and become more engaged and excited about school, said Perez, 38, a petite, soft-spoken mother of four who works as an office assistant for a furniture company.

In play therapy at Erie, “they’re able to be free in what they want to say because Mom is not there,” Perez said. “Now Angie is very blunt, and I think that’s because of therapy. And I love that, because I’m not scared that she’s holding something in.”